And He saw our affliction

And He saw our affliction (Deut 26:7) This refers to the disruption of family life as it states, “And God saw the Jewish people and God knew.” Passover Haggadah

It is no news that Sarah and I have been going through the amazing suck-fest that is infertility for the last several years.

There’s a lot of moments of trying to hold it together while acquaintances are gushing about the latest {pregnancy | childbirth}, (the friends mostly don’t do that to us) and there’s the pit in the stomach that comes once that gets started – the sense that this is not going to be a good night. There’s the intrusive medical stuff – shots, pokes and prods, testing, monitoring and sampling, the mind-numbing expense of it all, but the worst for me is the question of why God puts this particular barrier in our way – given that the first commandment is to be fruitful and multiply, how is this fair at all?

And then I beat myself up for asking about fairness – because honestly, I’ve had more than my share of blessing in this world, and “fairness” would mean that all I should get is an unmarked grave. Didn’t the patriarchs and matriarchs all face this? Yes, but according to the text they were pissed off too, so maybe that’s okay.

So what’s new in this is that Sarah and I have finally come to believe that IVF is the way we need to go. Sigh.

Now, this morning, I mentioned this to someone, and s/he told me “you can always adopt”. I presume s/he was trying to offer helpful advice, but s/he was actually being extremely hurtful. I pulled him/her outside and corrected him/her privately, and let the person know why that was such an unhelpful suggestion.

First, neither Sarah nor I are genetic snobs – we both believe that love is thicker than blood. I learned this from my maternal grandparents zt”l (may the memories of the righteous be for a blessing) – our family would routinely pick up “strays” for lack of a better word – family friends, distant cousins, in-laws, out-laws, etc, and then a gathering just wouldn’t be complete without them. This is a characteristic of my grandmother in particular which ranks her as a person whom I want to emulate – she and my grandfather are two of the finest human beings I’ve ever known. Sarah and I have long said that we want to be parents more than we want to be pregnant, so adoption was certainly not ruled out.

That said, adoption does have challenges, and only a fool would ignore that, so we had looked at it as a “second” choice, but preferable to IVF, when we started having miscarriages two years ago. We went to an informational session at a local agency (not linked for their privacy), and what we learned shocked us.

We had always thought that there was this vast number of children waiting in orphanages to be adopted, that there was a need for parents to step up, and that the real challenge was just getting qualified as an acceptable home.

HAH!

We could not have been more wrong.

So it turns out that in truth the number of infants who are adoptable in public adoptions (and by that I mean by non-relatives, via agencies), is a tiny fraction of the number of parents who are waiting in line to do the adopting. That agency we went to was one of the largest in the Mid-Atlantic region, and they placed 40 children in their busiest year recently, with a more typical year being closer to 25.

According to an adoption advocacy group (you have to dig for the number here – it’s table 1, column 7), 22,291 infants in the United States were placed for adoption in unrelated domestic adoptions. (Statistics on adoption are extremely opaque for some reason, and get aggregated in ways which obscure that truth).

By comparison, according to the CDC, the various types of Assistive Reproductive Technology (ART) which includes IVF, IUI, and procedures which happen in an office but does not include fertility injections or pills, 61,610 infants were born as the result of ART in 2011.

So adoption is actually, from a statistical point of view, not a better bet than IVF.

So why was it so bad for him/her to suggest this?

First, it was unsolicited advice, which honestly isn’t welcome on touchy, sensitive subjects. I don’t know how other people who are going through infertility feel, but as for me, I’m mourning the loss of some innocence – that something which I thought would be easy is going to not take climbing a mountain – it’ll take picking up the mountain and walking under it.

Second, the adoption agency said that you have to “market” yourself – you have to “sell” yourself to the birth mother, who will select your family from several families who are presented to her. So you’re competing with other families who all have similar if not the same dream of being parents, and remember what I said about “fair” before? Well, that applies here too – so how can I feel good about competing with other people in a way where if I win, someone else loses their dream? Geez, that’s horrible. That’s zero-sum thinking at it’s worst, and yet I can’t seem to escape it when thinking about how the agency presented how you have to behave. The agency (and everyone we’ve talked to about it) says you basically have to be willing to throw the extremely sharp elbow to be successful – you have to be completely focused and goal-oriented, and willing to be “that guy.” Even if you go the “hire a lawyer to do a “private” adoption, you’re basically outsourcing the problem of moral agency – I’m asking someone else to throw the sharp elbow on my behalf.

I’m not willing to rule it out – I won’t say I wouldn’t adopt, but after that info session, it dropped to the bottom of the pile below IVF.

Third – and this doesn’t, fortunately, apply to us – there are lots of couples where one partner is okay with adoption and one isn’t – the same is true for any other particular technology (egg donor, sperm donor, IUI, IVF, blah blah blah) – so saying “you can always do X” can be twisting a knife into someone who is already experiencing marital strife – and this is a painful, painful issue.

I can’t really explain the depth of feeling to anyone who hasn’t been through it – it’s experiential and awful, and can become consuming.

We’re happy to hear individuals’ experiences regarding their own journey, but suggestions like “have you tried relaxing” and the like are so profoundly not helpful, and in fact are hurtful.

11 Responses to And He saw our affliction

In case it’s helpful: I have been to REs at Johns Hopkins and Cornell, and Johns Hopkins is excellent both in absolute terms and in comparison to Cornell. The JH doctors were concerned about avoiding OHSS (ovarian hyperstimulation), not just getting large numbers of eggs. The nurses were always kind and patient, both the IVF nurses and the surgical nurses. I think it was worth the trip to Baltimore, even for the monitoring. JH’s numbers are not as good as other ART clinics because they are not selective in terms of which patients they accept, but I have every reason to believe that they are much better than others. The risk with REs is feeling less agency or objectified or like your opinion doesn’t count or like you’re lucky even just to be seen by the doctor, and that’s how I felt at Cornell. It’s really night and day. No idea what the DC options are. I wouldn’t have seriously considered Shady Grove or the other for-profits at the time I was looking for an RE, only academic medical centers, and the academic medical centers in DC didn’t seem appropriate.

The one consult we’ve had so far was with an academic place which likewise accepts all comers, and thus has the crummy rates. The other places we’re looking at have better rates, but some of that is certainly patient selection.

As always, David, I am with you and your family (Sarah and Kacy) with my heart and soul and want the best to happen for you. I have no experience in this issue (with humans) myself, but didn’t want to just stalk this posting. I can say I appreciate how painful this is for you guys and desperately want you to find peace throughout this process of growing your family.

Hey, Of course I know none of your medical details and you did a great job of explaining why unsolicited advice is the worst, but… if you guys would consider medical tourism in Israel nothing would make me happier. Apparently, Israel is a common destination for couples seeking high quality fertility treatment at costs much lower than the US. And the best part- you get to be in Israel!! Fine, fine. Just a pipe dream of mine. I truly hope you get the medical care and quality you are seeking close to your home and an answer to your tefillot. Lots of love from your favorite Jerusalem residents.

A couple of folks have suggested this to us- the logistics are pretty brutal, and would effectively mean that we’d need to move there, with all of the work implications that entails (ie that I would have to change jobs), and so that’s a LOT of doing.

I don’t think the success rates there are measurably better than good clinics in the US- I think the big benefit is price, so that’s a huge help for people with more flexibility than we have at this point, but isn’t the best option for us right now. We’d still love to see you, and hopefully life will let us get back there in the near term.

David,
I am sorry to hear about your troubles. I wish you the best of fortune with ivf. The couple next door to us has used ivf. They have had one successful pregnancy as a result. Tried two or three times. Shaw is a beautiful four year old who has just mastered my name. I would love for you to have similar results. I am so glad you found each other. Let go of the negativity. Most folks on this planet of ours have forgotten how to think, much less to be sensitive to the needs of others. Do not give them the power to hurt your hearts. Find something about the power of your subconscious mind. I know you are a reader, I imagine Sarah is too. Your subconscious mind is very powerful, however it is”programmed” by your conscious thoughts and words. accentuate the positive eliminate the negative. I would live to talk to you about this. I know time and space have taken us down different paths. But I will always be here for you. You should call.REDACTED. Loves auntie M

David and Sarah, thinking of you lots. Wish I had something useful to say, from a perspective of having done a lot of this already. And it hasn’t worked for us (yet) but I am still a believer that it could work for others, and hopefully you. For what it is worth – when I can take a broad view and disassociate my own emotions from the whole thing, it is absolutely amazing what science can do!

My husband and I went through this, eventually deciding on IVF. On our third cycle, we conceived a healthy twin pregnancy, the products of which are now two extremely opinionated two year olds. Oddly enough, we conceived 20 months later with no medical intervention, with another happy outcome. My unsolicited advice: take deep breaths, ice the injection sites, and keep asking Hashem for the gift of children. I pray that whichever doctors you choose will be shlichim for Hashem to bring you your children speedily, and also that any delay doesn’t mean no, it just means not yet, but rather soon.